Healthcare Provider Details

I. General information

NPI: 1164606232
Provider Name (Legal Business Name): ROBERTA LYNNE ZUCH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/24/2007
Last Update Date: 12/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 N TENNESSEE ST SUITE 203
MCKINNEY TX
75069-4358
US

IV. Provider business mailing address

116 NORTH TENNESSEE SUITE 203
MCKINNEY TX
75069
US

V. Phone/Fax

Practice location:
  • Phone: 972-396-4900
  • Fax: 972-396-4901
Mailing address:
  • Phone: 972-396-4900
  • Fax: 972-396-4901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: